Legislation expands Medicaid

Roosevelt General Hospital CEO Larry Leaming says there's a lot of uncertainty of what's to come from the Affordable Care Act.

What Leaming and other providers see as such a nebulous piece of legislation has them concerned about the effects it will have, but Leaming says one thing's for sure, it will not change who they serve.

"We're not turning anyone away from care and that won't change," Leaming said. "We'll fight to maintain quality of care. We don't belong to anyone other than the people of Roosevelt County. They're our prime, they own the place."

Leaming says the Affordable Care Act may have been created with good intention but feels no one truly knows the outcome of how the cost will be paid for.

"There's a lot of wait and see," Leaming said.

He says he's seen no change yet at RGH, but predicts things will change when more of the population becomes insured with implementation of the New Mexico insurance exchange and the expansion of Medicaid.

He added there's a lot of hidden taxes in the act such as a medical device tax that he predicts suppliers will pass on the cost to the hospitals.

"People here will opt out (of insurance) and we'll take them," Leaming said. "We discount the cost based on the person's ability to pay."

Plains Regional Medical Center Administrator Hoyt Skabelund says he hasn't seen any change at the Clovis hospital either but is enthusiastic about the expansion of Medicaid.

"The change that recently occurred can be very positive for hospitals and physicians," Skabelund said. "New Mexico will participate in the expansion of Medicaid."

According to a Gallup poll, New Mexico ranked number nine among states with the highest percentage of uninsured residents and Skabelund said the expansion of Medicaid will now cover a large portion of that uninsured population.

"To have this additional Medicaid to cover the uninsured could be a real blessing to hospitals and it will help ensure the high quality care we provide," Skabelund said.

He added that this should provide millions of dollars to help compensate hospitals and providers for accountable care which will serve as a benefit to average citizens because it reduces the cost shifting from those who are insured to those who are not.

"In a way, everyone wins," Skabelund said.

Seferino Montano, CEO of La Casa clinics, senses a fight brewing to retain providers in rural areas such as Roosevelt and Curry counties.

"There's a lot of changes going on within the provider sector," Montano said. "We have one year between now and 2014 when the mandate comes about."

Montano says with the expansion of Medicaid, about 85 percent of the 7,000 to 8,000 population they serve at his clinics will be eligible for Medicaid or private insurance through the exchange.

"That means physicians are being lured primarily by hospitals," Montano said. "We're contending with hospitals to staff clinics throughout state of New Mexico. They're developing more networks to take this new insured population that's going to be here."

Montano says he's already been faced with this challenge to staff clinics and fears he won't be able to find the amount of personnel that will be required to meet these changes.

"Rural areas have the hardest job of recruiting simply because we don't have the amenities the bigger cities offer," Montano said. "It boils down to a lot of competition. Before nobody wanted them (uninsured patients), once they're insured, then of course everybody wants them."

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